Regular alcohol use, binge drinking and regular illicit drug use (particularly marijuana) tend to be highest among 18-to-25-year-olds, according to the National Survey on Drug Use and Health. As marijuana is legalized in more states, teen access to and regular use of cannabis products is increasing. While some people see this as a normal part of adolescence, James McKowen, PhD, clinical director of the Addiction Management Recovery Service (ARMS) at Massachusetts General Hospital, cautions that when it comes to substance use, “The younger people start using, the more likely they are to have problems.”

Adolescents are also more vulnerable to developing substance use disorders because of how the brain develops. Reward pathways within the brain develop before control pathways—meaning that the parts of the brain that provoke caution and assess risk come on board later than those that send pleasure and reward signals. As such, it’s important for parents to pay attention and intervene as soon as a possible substance use problem is identified.

Tips for Families Facing Youth Substance Use

Substance use is hard not only on the user, but also on those around him or her. “Parents are struggling with a huge stressor, so we need to help them cope,” says Dr. McKowen. (ARMS offers services not just to teens and young adults, but also to their parents—even if their child is not ready for treatment.)

Dr. McKowen shares these tips for families facing child substance use:

1. Be a role model – Moderate your own alcohol/drug use. Do not use illegal drugs and never drive under the influence. If you have any mental health issues of your own, take care of them – you will be less effective as a parent if you aren’t taking care of yourself.

2. Reduce access – Look around your home and make sure your child does not have access to alcohol, prescription medications or other substances. Remember that the best way to prevent access at home is to simply get rid of these items—particularly unused or expired prescriptions. ( has a variety of resources explaining how to properly discard unused medications.)

3. Set clear expectations – Establish a clear no-use policy with your child. Have a discussion with him or her about the reasoning behind this policy, including the risks posed to the growing brain by early onset of substance use and legal issues that can result from continued use.

4. Follow through on the rules – This can arguably be one of the most difficult things to do, but it is incredibly important that you and your partner agree, and you stick to the rules once you’ve made them. Remember, too, that rules can include more than punishment—it’s often just as effective, if not more effective, to reward good behavior, rather than only punishing bad behavior.

5. Monitor behavior – This can also be a challenge, but research has shown that monitoring behavior is generally related to better outcomes. Keep in touch with your child so you know where they are going, who their friends are, when they’ll be home, etc. Many teens are very attached to their phones, so it may also be appropriate in some cases to monitor social media and phone use as well.

6. Get involved – Spend time talking to your child and really listen to find out what they care about. Be respectful in these conversations and avoid critical and judgmental statements. When you have opportunities to do so, get involved at school and with your child’s activities.

7. Support well-rounded activities – The specific activities don’t matter as much as simply being involved in activities outside of school. Encourage your child to nurture his or her interests by taking part in sports, music groups, community service projects, art classes, church activities or school clubs.

8. Reach out – Know that it’s okay to ask for help when you need it. Talk to your child’s primary care provider, guidance counselor or teachers when problems arise. If things have gotten more serious, consult with a specialist (like those available through the ARMS program at Mass General.

James McKowen, PhD, is a Licensed Clinical Psychologist and Clinical Director of the ARMS program. Dr. McKowen has expertise in working with adolescents and young adults with substance use and comorbid mental health disorders and their families. He conducts research on the neuropsychological effects of substance use in youth.

The Addiction Management Recovery Service (ARMS) is a program within the department of Psychiatry at Mass General that specializes in supporting teenagers and young adults between the ages of 14 and 26 and their parents as they deal with their substance use and related problems. ARMS is an outpatient, dual diagnosis clinic with a multidisciplinary team that includes clinical psychiatrists, psychologists and masters-level social workers who are trained to work with youth and their families to provide each patient an individualized plan for recovery.

Learn more about the Addiction Recovery Management Service